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Department of Alcoholic Beverage Control State of California APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) ABC 211 (6/99) TO:Department of Alcoholic Beverage Control File Number: 591466 31 E CHANNEL ST Receipt Number: 2484435 ROOM 168 Geographical Code: 3905 STOCKTON,CA 95202 Copies Mailed Date: February 28,2018 (209)948-7739 Issued Date: 'RECEIVED DISTRICT SERVING LOCATION: STOCKTON First Owner: KIRAN,LALITA MAR Q 5 us$ Name of Business: LK MINI MART Location of Business: 6025 PACIFIC AVE ENVIRONMENTAL HEALTH STOCKTON, CA 95207 DEPARTMENT County: SAN JOAQUIN Is Premise inside city limits? Yes Census Tract 0031.10 Mailing Address: I (If different from premises address) Type of license(s): 20 Transferor's license/name: 465190 / DHILLON,NARINDER KAUR Dropping Partner: Yes_ No License Type Transaction Tyne Fee Tyne Master Dup Date Fee 20-Off-Sale Beer And Wim PREMISE TO PREMISE TRANSFER NA Y 0 02/28/18 $100.00 20-Off-Sale Beer And Wim PERSON-TO-PERSON TRANSFER NA Y 0 02/28/18 $50.00 20-Off-Sale Beer And Wim ANNUALFEE NA Y 0 02/28/18 $283.00 NA FEDERAL FINGERPRINTS NA N 1 02/28/18 $24.00 NA STATE FINGERPRINTS NA N 1 02/28/18 $39.00 Total $496.00 Have you ever been convicted of a felony? No Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the Department pertaining to the Act? No Explain any"Yes"answer to the above questions on an attachment which shall be deemed part of this application. Applicant agrees(a)that any manager employed in an on-sale licensed premises will have all the qualifications of a licensee, and(b)that he will not violate or cause or permit to be violated any of the provisions of the Alcoholic Beverage Control Act. STATE OF CALIFORNIA County of SAN JOAQUIN Date: February 28, 2018 Under penalty of perjury,each person whose signature appears below,certifies and says:(1) He is an applicant,or one of the applicants,or an executive .officer of the applicant corporation,named in the foregoing application,duly authorized to make this application on its behalf,(2) that he has read the foregoing and knows the contents thereof and that each of the above statements therein made are true;(3) that no person other than the applicant or applicants has any direct or indirect interest in the applicant or applicant's business to be conducted under the Iicense(s)for which this application is made; (4) that the transfer application or proposed transfer is not made to satisfy the payment of a loan or to fulfill an agreement entered into more than ninety (90)days preceding the day on which the transfer application is filed with the Department or to gain or establish a preference to or for any creditor or transferor or to defraud or injure any creditor of transferor,(5) that the transfer application maybe withdrawn by either the applicant or the licensee with no resulting liability to the Department. . Effective July I,2012,Revenue and Taxation Code Section 7057,authorizes the State Board of Equalization and the Franchise Tax Board to share taxpayer information with Department of Alcoholic Beverage Control.The Department may suspend,revoke,and refuse to issue a license if the licensee4s name appears in the 500 largest tax delinquencies list.(Business and Professions Code Section 494.5.) Applicant Name(s) Applicant Signature(s) See 211 Signature Page KIRAN,LALITA